11/18. Endogenous klebsiella pneumoniae endophthalmitis in diabetic patients.We describe 12 patients with endogenous endophthalmitis caused by klebsiella pneumoniae seen between 1983 and 1988. Three patients had bilateral involvement. Eleven patients had diabetes mellitus, either newly diagnosed or poorly controlled. In six cases the infection was associated with a liver abscess. In all eyes the outcome was light perception or worse; nine eyes had no light perception. Six eyes were enucleated or eviscerated.- - - - - - - - - - ranking = 1keywords = perception (Clic here for more details about this article) |
12/18. Bilateral blindness from orbital cellulitis caused by community-acquired methicillin-resistant staphylococcus aureus.PURPOSE: To describe bilateral blindness resulting from infection with community-acquired methicillin-resistant staphylococcus aureus (MRSA). DESIGN: Observational case report. methods: A 44-year-old man developed proptosis, ptosis, ophthalmoplegia, and no light perception vision after attempting to lance a nasal pustule. A nasal culture grew MRSA. Imaging showed bilateral orbital cellulitis, pansinusitis, and cavernous sinus thrombosis. The right fundus showed severe ischemia, but the left fundus was essentially normal. RESULTS: Despite initiation of appropriate antibiotics early in the course of infection, the patient lost sight in both eyes. Surgical drainage of the paranasal sinuses and use of intravenous corticosteroids and heparin led to the resolution of orbital cellulitis. CONCLUSIONS: MRSA orbital cellulitis can progress to irreversible blindness despite antibiotic treatment. A new, community-acquired clone of this organism has exhibited increased potential for tissue invasion.- - - - - - - - - - ranking = 0.5keywords = perception (Clic here for more details about this article) |
13/18. Infectious keratitis related to orthokeratology.PURPOSE: To report 28 cases of infectious keratitis related to orthokeratology lens overnight wear in china. methods: From March 2000 to August 2001, 28 cases of infectious keratitis related to overnight orthokeratology lens wear were diagnosed in Beijing Institute of ophthalmology. These were retrospectively reviewed with regard to the pathogens isolated, duration of wear, the time since onset of symptoms, and age. Cultures of corneal scrapes for bacteria, fungus and acanthamoeba were performed in all of the 28 cases. RESULTS: All cases were students, including 10 males and 18 females, average age was 16 years (range 10-21 years). The duration of orthokeratology overnight wearing was from 2 weeks to 2 years. Uncorrected visual acuity (UCVA) on initial examination in our institute was from 20/200 to light perception. Of 28 isolates, 24 were culture positive (including 11 bacteria, 11 acanthamoeba and two fungi), and four were culture negative. In two of the four culture negative cases, acanthamoeba cysts were detected in the corneal stroma with the confocal microscope. acanthamoeba and pseudomonas aeruginosa accounted for 75% (21 of 28) of the cases of infectious keratitis. CONCLUSION: Infectious keratitis is a severe complication associated with overnight orthokeratology lens wear. Ophthalmologists should pay more attention to this complication in practice.- - - - - - - - - - ranking = 0.5keywords = perception (Clic here for more details about this article) |
14/18. Pneumococcal endophthalmitis associated with nasolacrimal obstruction.Pneumococcal endophthalmitis can be a devastating postoperative infection after cataract extraction or penetrating keratoplasty. streptococcus pneumoniae was isolated as the causative agent in three of the 124 patients (2%) who were treated for endophthalmitis at our institution between 1984 and 1990. Two of the three patients lost light perception in the affected eye. All three patients had previously unrecognized or untreated chronic nasolacrimal obstruction of varying causes. We studied the role of pneumococcal lacrimal conjunctivitis in the pathogenesis of the postoperative pneumococcal endophthalmitis in these patients.- - - - - - - - - - ranking = 0.5keywords = perception (Clic here for more details about this article) |
15/18. Postoperative endophthalmitis resulting from prosthesis contamination in a monocular patient.Monocular patients who wear an ocular prosthesis may harbor pathogenic conjunctival flora both in the socket and in the contralateral eye. They may therefore be at increased risk of developing endophthalmitis after intraocular procedures. We studied a monocular, prosthesis-wearing, 86-year-old man who underwent cataract extraction, subtotal transpupillary vitrectomy, and intraocular lens insertion. Fulminant endophthalmitis ensued postoperatively, and despite complete vitrectomy and administration of intraocular antibiotics, the eye lost light perception. Intravitreal as well as conjunctival cultures bilaterally grew proteus mirabilis. The patient disclosed that he cleaned the prosthesis frequently because of discharge. We considered an association between this bacterial colonization and the risk of developing postoperative endophthalmitis and suggest prophylactic measures for treatment of monocular patients undergoing intraocular procedures.- - - - - - - - - - ranking = 0.5keywords = perception (Clic here for more details about this article) |
16/18. Scleral flap necrosis and infectious endophthalmitis after cataract surgery with a scleral tunnel incision.BACKGROUND: Long scleral tunnel dissection techniques have been developed for cataract surgery incisions. These incisions reduce postoperative astigmatism and keratorefractive instability. If fashioned correctly, the internal lip of the incision produces a tight seal to the anterior chamber, permissible of sutureless surgery. The behavior of such a wound during intraocular infection is unknown. methods: The authors describe two elderly patients in whom postoperative bacterial endophthalmitis was accompanied by infectious scleritis, infectious sclerokeratitis or keratitis, and rapid scleral flap necrosis. One of the patients had a painless disease process. RESULTS: Intraocular isolates of Staphylococcus aureus and Streptococcus equinus were recovered from the two patients, respectively. Management was complicated by loss of tectonic integrity that followed scleral flap necrosis, by impaired vitreoretinal visualization associated with rapidly progressive sclerokeratitis or keratitis, and by bacterial scleritis in the base of the scleral flap. No light perception was retained in either eye. CONCLUSION: Scleral tunnel incisions create a potential abscess cavity. Although a rare occurrence, postoperative endophthalmitis in such an eye may present major surgical and therapeutic problems intrinsic to the wound design.- - - - - - - - - - ranking = 0.5keywords = perception (Clic here for more details about this article) |
17/18. endophthalmitis caused by nutrient variant streptococci after filtering bleb surgery.Late-onset endophthalmitis after filtering bleb surgery is most often caused by streptococci. We report the first case of endophthalmitis caused by nutrient variant streptococci (NVS), which probably originated from the oral cavity. This patient's vision improved from light perception to 20/80 with intravitreal and systemic antibiotic administration. In late-onset endophthalmitis, NVS can be pathogenic; the laboratory must be alerted to culture specifically for this fastidious bacterium.- - - - - - - - - - ranking = 0.5keywords = perception (Clic here for more details about this article) |
18/18. endophthalmitis and orbital cellulitis after radial keratotomy.PURPOSE: To report the findings concerning three patients with endophthalmitis and one with panophthalmitis and orbital cellulitis radial keratotomy surgery. methods: One man referred with panophthalmitis and orbital cellulitis and three women referred with endophthalmitis were treated. RESULTS: After radial keratotomy surgery, during which no microperforation or macroperforation had been reported, a severe Pseudomonas panophthalmitis and orbital cellulitis developed in the man. All vision was lost in that eye. staphylococcus epidermidis endophthalmitis developed in one woman, streptococcus pneumoniae endophthalmitis in the second woman and Pseudomonas endophthalmitis in the third woman, after undergoing radial keratotomy procedures during which microperforations occurred. In the latter patient, bilateral simultaneous surgery was performed, but only one eye became infected. The latter two infections resulted in light perception and hand motion vision respectively. In three cases, an initial keratitis was located in the inferior cornea. CONCLUSIONS: Severe bacterial endophthalmitis can occur after radial keratotomy surgery, even in the absence of microperforation during the procedure. Any evidence of postoperative keratitis must be regarded seriously and treated aggressively. Despite use of this approach, the effect on final visual acuity can be devastating.- - - - - - - - - - ranking = 0.5keywords = perception (Clic here for more details about this article) |
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